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Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study^*

Section of Neurobiology of Psychosis, Institute of Psychiatry, London, UK

MICHAEL LEWIS, BA, RMN

Section of Neurobiology of Psychosis, Institute of Psychiatry, London, UK

PAUL McCRONE, PhD

Centre for the Economics of Mental Health, Institute of Psychiatry, London, UK

Correspondence: Dr Sophia Frangou, Section of Neurobiology of Psychosis, PO66, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: s.frangou{at}iop.kcl.ac.uk

Declaration of interest The study (excluding attendance or presentations at international conferences) was supported by Laxdale Ltd, supplier of the ethyl-EPA preparation used in it.

^* This paper was presented atthe 3rd European Stanley Foundation Conference on Bipolar Disorder, Freiburg, Germany, 12-14 September 2002.

Background Epidemiological and clinical studies suggest that increased intake of eicosapentaenoic acid (EPA) alleviates unipolar depression.

Aims To examine the efficacy of EPA in treating depression in bipolar disorder.

Method In a12-week, double-blind study individuals with bipolar depression were randomly assigned to adjunctive treatment with placebo (n=26) or with 1 g/day (n=24) or 2 g/day (n=25) of ethyl-EPA. Primary efficacy was assessed by the Hamilton Rating Scale for Depression (HRSD), with changes in the Young Mania Rating Scale and Clinical Global Impression Scale (CGI) as secondary outcome measures.

Results There was no apparent benefit of 2 g over 1 g ethyl-EPA daily. Significant improvement was noted with ethyl-EPA treatment compared with placebo in the HRSD (P=0.04) and the CGI (P=0.004) scores. Both doses were well tolerated.

Conclusions Adjunctive ethyl-EPA is an effective and well-tolerated intervention in bipolar depression.

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